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FeatherBoa writes "A Manitoba man who was one of the first entrepreneurs in the cross-border online pharmacy industry has been arrested in Florida and is facing charges related to the sale of foreign and counterfeit medicines. The U.S. Food and Drug Administration claimed many of the drugs promoted as Canadian actually came from other countries. An FDA spokesperson commented, 'Many of these websites are operating outside of the United States. However, the internet's broad reach allows these websites to reach U.S. consumers.'"

"The U.S. Food and Drug Administration is vigilant and stops a guy who helps people buy what appear to a layperson to be the health products they want to buy but are in fact frauds that will kill them or do nothing while getting them to avoid proper treatment."

I'm not sure which is right, because I don't have the facts of the case, but it's quite possible that what the FDA is doing is a good thing.

Well at the very least you have to assume that someone trying to sell you a drug with limited ad space is far less likely to disclose all the potential side effects and dangers then your local pharmacist/doctor (who are legally bound to not lie to you).

Sure, that is a serious risk, but when some people have to choose between rent and their medication, it is a risk that they might be willing to take. If your doctor prescribed a medicine that cost you $200 even though you were insured, and that $200 would be the difference between eating and not eating, what would you do? Your choices are basically (a) forgo treatment or (b) seek a cheap alternative.

The medical industry has found that it is best to take advantage of the sick by reducing production and increasing demand.
For example, over the counter Vial of 70/30 humalin in 2002 was $20, now it is $76. 10 years later it has "inflated" well past even grocery store inflation.
The cost of gas is not the cause.

That product is long, long out of patent protection and available in generic form. No single company should be able to constrict demand. Even if that is the case, then they fall under antitrust laws and a suit should be filed.

Most of the drugs that have been subject to shortages have been generics. Cheap generics. Even after all of the hue and cry about the shortages (this is apparently a US only issue) it isn't very clear exactly WHY the drugs are in short supply. It may well be that they are too cheap - it's simply not profitable to make the drug, test it and deal with the various regulatory agents for the price the market will bear. It may be that the generic companies don't have their manufacturing acts together. It may be an evil conspiracy set in place by the Illuminati. It may be all of the above.

Antitrust has (likely) very little to do with this. In fact, most of the drugs that I've seen that are short supplied have numerous sources - at least from the pharmacy ordering end. Whether or not there are multiple manufacturers is harder to discern.

And further, even for generics, the inflation rate has tracked way past pretty much everything else for years.

The most likely explanation I've heard is similar to the diamond situation. If someone wants to start producing pharmaceuticals at a rate that would harm the big boys profits, they (would) simply lower the cost temporarily and drive the newbie out of business.

Combine that with a dab of conspiracy; they'll only continue selling the "good stuff" (new drugs) at semi-affordable prices if everyone plays ball and makes sure they still get a decen

Teva (lit. "nature"), an Israeli pharmaceutical manufacturer who did most of their fortune from generic drugs, is, today, either the biggest or second biggest manufacturer in the world (though they did so many mergers and acquisitions that their name does not always appear on the package).

They are also the #1 reason that Israel is a permanent member of the US's intellectual property black list, despite the fact that Israel's pharmaceutical patent law actually lives up to the standards set forth by the US. I

Sure, that is a serious risk, but when some people have to choose between rent and their medication, it is a risk that they might be willing to take.

Note that the FDA apparently isn't prosecuting the people who bought from this guy, just this guy for defrauding his customers. He was, according to the summary, selling drugs he claimed were manufactured in Canada but were in truth manufactured who knows where. That's fraud. Misrepresentation.

Yes, the people should be able to take their risks. They should be told the truth about those risks before deciding, though.

My assumption is that the FDA is acting like my daddy, and I'm just a little kid, too stupid to make my own choices and decisions. Maybe I WANT to buy medicine from Canada. Maybe I am VERY aware of the risk, but willing to do it anyway. Maybe I believe if a problem existed, then CANADA would handle it, under their false-advertising laws.

In any case, just as abortion if MY choice, buying pills online should be MY choice, and not have to worry about the FDA sending me to my room like a bad little kid. I am sick-and-tired of this BS where the government thinks citizens are children who have to be cared for.

It is unfortunate that, all too often, "The Truth" is sold by those with a financial interest greater than the cost of the truth. The doctors and pharmacists have culpable deniability because they are just going on what they were told and in the end, it is the patient that suffers.

Oxycontin comes to mind as a very recent example of this behaviour, and I'm sure when all is said and done, this guy will walk away paying a fine that is but a fraction of

The FDA is enforcing trademarks for US business interests. Nothing more, nothing less. They might stop someone from taking a harmful counterfeit drug, but they will also stop many from getting the drugs they need. Whether the former is greater than the latter, I doubt if they considered for an instant.

Finland isn't some 3rd world libertarian paradise. They have actual effective drug safety laws that seem to work better than the U.S. version. Same for Canada or the U.K.

If there was a way to region code drugs, that's what would happen, but since there isn't, the FDA has to step in and make sure Americans can't wriggle out of the pay our extortion or die deal they are offered.

If it was not illegal to import drugs and medical devices, people wouldn't be forced to deal with these small, fly-by-night operations in the first place.

Consider the illegal drug trade. If you get burned by someone selling you powdered sugar while claiming it is cocaine, you basically have little recourse. You can't call the cops. You can't file a claim with the BBB. You can't organize a boycott or widely publicize the fact that they sold you garbage.

You're just a full of shit conspiracy theorist unless you can prove your case.

He has conflated two different situations that apply here, but not even remotely "full of shit"

As the first situation applicable here, US (and other well-regulated "First World") pharmaceutical companies sell their drugs much, much cheaper to literally every other country in the world than they do in the US. Why? Because we have the single least dollar-for-dollar-effective healthcare system in the world, simple as that. You can buy cheaper drugs outside the US simply because they cost less outside the US.

Second, you have relabeled/expired/non-drug drugs sold fraudulently by unethical parties in some places outside the US. This doesn't differ in the least from buying your home theater kit off the back of some guy's box tuck on the side of the road; You may get it cheap, but you have no idea what you've really gotten.

The problem here comes from the FDA lumping all reimportation under the same banner. The first kind has absolutely no justification beyond protecting industry profits within the US. The second kind depends on the rigor of the applicable laws in the country from which you buy.

Some - I dare say most - of us believe that if you buy from a country with substantially similar drug safety laws to the US, the FDA should stay the hell out of the situation. If, however, you find a great deal from a Nicaraguan online pharmacy... Well... Personally I still say the FDA should butt out, but definitely more of a caveat emptor situation than nice safe we--regulated Canadian pharmacies.

Probably true, but this is more a problem with HealthCanada than the FDA.

If I buy my drugs from a Canadian Pharmacy, I know (or should know) that I will be subject to Canadian regulations and quality control standards. The FDA's involvement in this should be no more than to inform me of this fact.

What broke down is HealthCanadas oversight of this guy's operation. The article seems to suggest that Strempler "every intention of conducting an ethical and professional business". Of course, that was one of his online pharmacy buddies opinions.

The FDA cannot assure the safety and efficacy of products that are purchased outside of legitimate channels.

HealthCanada isn't legitimate? Well, maybe not. So the solution should be: deport Strempler and see how the Canadians deal with him.

I'm all for the FDA keeping the American public informed as to what meets standards and what does not. But this situation isn't much different than me visiting Tijuana and eating at a local taco stand. The health codes aren't up to US standards, but I know that.

HealthCanada my be legitimate, but it isn't the FDA. It may be better or worse then the FDA, but that isn't the point, it is because they are not approved threw the FDA.

The difference is if you go across the border to get your drugs or a Taco, you know you are leaving FDA rules, and you accept the risk. If you are in the United States, you expect what ever you buy there should be within the rules of the FDA.

Here's an idea that's been floated before - allow drugs approved by a few other agencies to get imported. Agencies from large industrialized countries who appear to be doing at least as good a job as the FDA in weeding out counterfeit and poorly made drugs. Does anyone think that the Canadians or French or Germans are falling over left and right due to contaminated drugs? Does anybody think the FDA is perfect?

This sort of thing could be done in the space of a year or so. It would solve a number of probl

Does anyone think that the Canadians or French or Germans are falling over left and right due to contaminated drugs?

No, we are not. However in all fairness, in reverse I would not want to take drugs that the FDA had approved but which Health Canada had not (unless the risk was medically worth it) because of things like bovine growth hormone which the FDA (or at least some US government agency) has approved for use on cattle which enter the human food chain but which very few (any?) other countries have. While Americans may not be keeling over from this it is known to affect the development of children and potentially ma

The difference is if you go across the border to get your drugs or a Taco, you know you are leaving FDA rules, and you accept the risk. If you are in the United States, you expect what ever you buy there should be within the rules of the FDA.

I kinda guessed the same thing by the way they proudly called themselves a Canadian pharmacy. When I order something from Canada, I expect that it falls under all relevant Canadian laws and regulations.

More like ordering delivery from that Tijuana taco stand. I bet if you operated a taco stand just on the other side of the border and tried to deliver into the USA, you'd get busted for that too. The FDA has also been cracking down on the production and sale of Mexican Bathtub Cheese [colostate.edu] and raw milk, despite the fact that most of the people imbibing those particular delicacies are well aware of the potential risk.

But this situation isn't much different than me visiting Tijuana and eating at a local taco stand. The health codes aren't up to US standards, but I know that.

Not really. Unless you're a dispensing pharmacist or medial professional, you're unlikely to be able to tell if the little yellow pill you ordered online is in fact your gout medication, a generic antihistamine, or worming meds for cats, and you won't know until your gout gets worse.

Unless you're a dispensing pharmacist or medial professional, you're unlikely to be able to tell if the little yellow pill you ordered online is in fact your gout medication, a generic antihistamine, or worming meds for cats, and you won't know until your gout gets worse.

Unless you're a dispensing pharmacist or medial professional, you're unlikely to be able to tell if the little yellow pill you ordered online is in fact your gout medication, a generic antihistamine, or worming meds for cats, and you won't know until your gout gets worse.

Unless they have a GC/MS machine, I doubt a dispensing pharmacist or medial professional could tell either.

As a practical matter, some drugs really *are* "too cheap to counterfeit, and are expensive in the US only because we allow "use" patents, while other countries (like India) only recognize "manufacturing process" patents. So, drugs like finasteride (Propecia & Proscar) and atomoxetine (Strattera) are expensive in the US, and practically free in India.

Some drugs, like Tamiflu, *are* genuinely expensive to manufacture, easy to counterfeit, and *likely* to be fake.

>me visiting Tijuana and eating at a local taco stand. The health codes aren't up to US standards, but I know that.

Thank you for your racist comment. Mexico has health boards, thank you. How is the Tijuana stand different than the same stand operating in Far Rockaway? It isn't, except that you choose a racist example.

Yes and no. The crux of the FDA's argument is that some of the drugs come from other countries. That may be technically true but what the FDA isn't saying is whether these drugs are actually safe. Many pharmaceutical companies manufacture and sell in other countries. In some places the differences are minor. For example, a pain killer sold in Europe may have a higher dosage than allowed in the US but is the same drug. Or the the labeling is not in the correct language which makes it hard for the user

Although there are minor dosing issues, it has always impressed me on how similar foreign drugs. Omeprazole 20 mg (generic Prilosec) is the same thing in the UK and in Germany. The labeling issues are pretty silly. If you get a prescription of the same drug from two different pharmacies is will often have different warning labels. It's pretty random (and useless).

If the US hadn't adopted the metric system for drugs and remained on the 'grains' and teaspoon structure of the 1800's we might have a problem

Getting the same prescription from two different pharmacies should certainly NOT result in two different labels. If it does something is very wrong. The 'labeling' includes not only the sticker the pharmacy puts on the bottle, but also the patient information sheet that comes with the drug. The bottles may be different (they are not regulated), but the patient information sheet (the real 'label') is the same.

That's a mighty big IF you've got there. How do you KNOW it's the same drug? How do you know it isn't counterfeit? How do you know it was manufactured and handled under the same conditions as approved by the FDA?

They lie, therefore they can't be trusted. That's always been the pretense of stopping cross border pharmacy sales... the guise of stopping counterfeiting. In most cases the drugs sold are legitimate.

The U.S. drug market commands some of the highest prices in the world. The pharma companies artificially inflate the prices to sell to Americans. Isn't "capitalism" grand? Cross border sales are simply the "free market" coming to the rescue but oh no... there's too much bribe money ("lobbying") for that to happ

The fact that it's illegal to import drugs and medical devices is precisely what enables the snake-oil salesman who are only looking to make a quick buck in the short term.

Get rid of the import ban and legitimate businesses will spring up to fill this need. Those companies will have a desire to stay in business and will be concerned about quality and their reputation. Not to mention that they would be subject to U.S. tort law.

The FDA can add whatever spin they want. Their mission in cracking down on thes

And how, exactly, do you propose to have any knowledge that what the FDA describes in the documents and what you actually got are anywhere near the same thing? Or are you really stupid enough to believe that just because you received a bottle that says 'lisinopril 10mg' that is what it really is in an unregulated environment? Or maybe your wonderful super-fast communication will get the word out that bottles marked 'lisinopril 10mg' are dangerous, and you should not take them? Of course, if you have the

If it comes from an actual Canadian pharmacy, I would be relying on Canada's laws and regulations to make sure it was what it was supposed to be. Much as I rely on U.S. laws and regulations when I buy it from the CVS down the street.

He said that the ONLY function of the FDA should be "gathering and publishing data on whats in a drug and what side effects have been observed. Period". Which means there are no US laws and regulations to rely on when you buy it from CVS.

I see. So the FTC takes over the role of making sure that the drugs are safe and effective, and the FTC makes sure that the drugs are manufactured and handled correctly. And the FTC takes over making sure that the drugs are only sold by licensed pharmacies, etc. And how, exactly, is that any different, other than the name of the agency, from the current situation?

Yeah, the stuff came from Canada. Except for the stuff that he said came from Canada but actually came from somewhere else. As for 'working for US pharma (ooh, evil!)', are you saying that the FDA does not approve drugs from non-US companies? Bullshit.

As long as it was consistent with Canadian law, I don't care. A lot of drugs sold in the U.S. don't come from the U.S. either, but they met the necessary regulations.

What the FDA is doing is helping to support the massive price hike that happens as soon as you take one step south of an invisible line. A price hike that leaves a lot of people choosing between food and necessary medication.

From TFA: The current charges come two years after Strempler agreed to have his name removed from the Manitoba Pharmaceutical Association registry. That move came after disciplinary hearings in which the association alleged Strempler's company sold drugs from overseas locations that weren't approved by Health Canada.

So even when he was registered as a pharmacy in Canada he wasn't selling drugs approved by Canada.

The U.S. Food and Drug Administration is bored and screws with a guy who helps people buy the health products they want to buy. News at 11.

While what he is doing may be shady, I will say that Canadian drug stores enabled my mom to take a much more expensive brand-name drug that she wouldn't otherwise be able to afford. This drug was not covered on her insurance, and the ones that were covered were not effective for her condition.

She refused to let her children buy it for her, but when I found it online for 20% of the price (after pill splitting), she was able to afford it.

The problem I wish the FDA would address is exorbitant drug prices in the USA compared to what the rest of the world pays.

I have sufficient faith in Canada to pop pills regulated by them. But the summary says: "The U.S. Food and Drug Administration claimed many of the drugs promoted as Canadian actually came from other countries."

If true, this is effectively sandwich-baggie stuff, plus false advertising.

Canada puts price controls on their drugs. If every country put price controls on drugs, you might find many less new drugs making it to market.

So you mean Canada is abusing our drug industry by forcing the drug companies sell drugs below cost? Why don't the manufacturers refuse to sell at such low prices? Is there some international law that forces drug manufacturers to sell drugs at any price set by any country?

Maybe lower prices would mean fewer drug ads on TV and fewer multi-page magazine advertisements? How much of a drug's total cost goes into marketing?

This drug was not covered on her insurance, and the ones that were covered were not effective for her condition.

Name and shame?

I think it was Prandin, a diabetes drug. This was the only drug that proved to be effective for her

This was several years ago and her monthly cost dropped from around $350 at the cheapest domestic place she could find (she compared a number of local pharmacies including Costco, Walmart and others and some mail order places) to under $60 by buying from Canada. I don't know what current prices are.

If he is not selling drugs and properly reporting where they come from, it could be a major health concern. For those who work in the Health Industry, You need to be sure that everything is properly documents and reported correctly. Ok you get these pills from a tiny nations (who seemed to be a major exporter of sugar) at 1/10th price, which appears to be brand name drug. Now you my be actually getting the real drug, or a forgery made from sugar, or worse, a copy from some of the active ingredients at diff

> Now you my be actually getting the real drug, or a forgery made from sugar, or worse, a copy from some of the active ingredients at different percentages, or different drugs all together.

There's a lot of FUD in that statement. Pretty much everything in the US comes from foreign made suppliers, except for drugs, because apparently Taiwan can make state of the art hard drives but can't mix two chemicals together.

There are plenty of reputable offshore drug suppliers and they're usually much much cheaper

The U.S. Food and Drug Administration is bored and screws with a guy who helps people buy the health products they want to buy. News at 11.

Actually he was buying generics made in different places(China and India) and re-packaging them as made in Canada, they may have been tested(no paperwork was ever produced to say so as far as I know). He turned in his pharmacy license before he could be convicted of fraud, unethical behavior and malpractice.
He was an idiot to be in the US, he knew there were open outstanding warrants for him in the US.

Yeah. You know what, you should really stick it to them by buying a bunch of drugs from me at a bargain knock-down price that undercuts Big Pharma! Go on, it'll really piss them off, and I guarantee that there's not much rat poison, baking powder and whatever dust I found in the attic in my "remedies"!

Most of these online pharm orders are for non-medical reasons. The most popular, phentermine, is used to make speed. Other popular meds, viagra, cailis, didrex, are used recreationally. Knowing this, it's hard to sympathize with the online pharmacy industry.

Canadians can still fly on plenty of domestic airlines, and I doubt an Air Canada flight that passes over, say, Alaska on the way to Tokyo, is going to divert to the US to arrest somebody.

In terms of if the FDA is overreacting, I'd suggest that if Canadian authorities aren't arresting the guy in Canada, then whatever he is doing is probably not bad enough that the FDA should get involved when he visits the US.

Canadians can still fly on plenty of domestic airlines, and I doubt an Air Canada flight that passes over, say, Alaska on the way to Tokyo, is going to divert to the US to arrest somebody.

Sometimes flights get diverted for other reasons (technical problem, medical emergency,...) and the US will know that you are on the plane because they require access to PNRs for flights passing over US airspace.

Sure it's unlikely to do so just to arrest somebody, but planes sometimes have to land where they aren't scheduled to. Which is why it was in the "just in case" sentence, it's an additional risk on entering US jurisdiction.

Canadians can still fly on plenty of domestic airlines, and I doubt an Air Canada flight that passes over, say, Alaska on the way to Tokyo, is going to divert to the US to arrest somebody.

The US demands passenger manifests and other information from every flight that overflies American airspace, even if they don't touch US soil - and I believe they even have the right to say no to the flight - either it land at a US airport and offload the objectionable passenger, or it bypass US airspace.

"But what is government itself, but the greatest of all reflections on humannature? If men were angels, no government would be necessary. If angels wereto govern men, neither external nor internal controls on government would benecessary. In framing a government which is to be administered by men overmen, the great difficulty lies in this: you must first enable the governmentto control the governed; and in the next place oblige it to control itself."

I cannot understand why anyone would see an add for drugs online and actually go ahead and purchase that online without doing to your doctor/pharmacist, talking to them about the drug and then getting it through official channels.

You have no reason to believe that any claims made by someone trying to sell you drugs online are true, and no reason to believe that the little white pills shipped to you are even what you ordered. At the very very least, you cannot be at all confident that other medications yo ar

I can think of several reasons people would do this:1. Some people are stupid.2. People are often on a very very limited budget, and the online option may appear at least to be cheaper than the drugstore.3. (Corollary to 1) Some people will diagnose themselves with illnesses that the doctor doesn't think they have, so they'll go and buy the treatment through channels that don't involve official doctors and prescriptions.4. People who abuse prescription drugs would likely find this a very convenient option.

There are a lot of uninsured and underinsured people out there. If you're living paycheck to paycheck, and you'll be out $150 of grocery money if you take an office visit (not to mention the time off of work you won't be getting paid for), then self-diagnosis on the Web and foreign pharmacies start looking like attractive options.

This is what people are forced to do in a for profit health care industry.

I cannot understand why anyone would see an add for drugs online and actually go ahead and purchase that online without doing to your doctor/pharmacist, talking to them about the drug and then getting it through official channels.

When a 30 day supply of a medication that greatly improves your life costs hundreds of dollars from legal channels, and only a fraction of that from online pharmacies, what do you do? This is one of the problems with health insurance in America -- you have uninsured and in some cases insured people who cannot afford medicines. There is also the consequences of the war on drugs, which leaves us vulnerable to the demands of pharmaceutical companies for medicines that can be grown in our backyards (and I a

Sure, that is a risk and it should not be downplayed. My point is that for some people, the choice is between not receiving treatment or taking a chance on an online pharmacy (or receiving treatment legally, but not being able to eat or pay rent).

Eh, it really isn't that hard: just adjust the prices of doing the things you talk about, and the available income of the person making the choice, and it all falls into place. Secondary cases would include people on long-term maintenance drugs and people who are looking to score some of the more interesting anesthetics. Unless you are reasonably well insured, even some fairly prosaic drugs can be painfully expensive through official channels, and getting a doctor to have a look, have a chat, and write the

> I cannot understand why anyone would see an add for drugs online and actually go ahead and purchase that online without doing to your doctor/pharmacist, talking to them about the drug and then getting it through official channels.

Well, I think it's stupid for anyone to take any med without talking about it with their doctor. That said, meds in the US are marked up to an absurd level. It's often much cheaper to talk with your doctor, get a prescription, toss that in the waste basket and just order the m

Seriously, I've seen doctors prescribe pregnizone without any mention of any potential interactions and side effects, and that's the kind of drug where the side effects are often worse than the symptoms being treated.

"Counterfeit" does not necessarily mean "fake" or "mislabeled," it may me "the real deal, but in violation of a patent or trademark." Unless the FDA is publishing a chemical test that demonstrates that these drugs were not what they claimed to be, I would bet that the word "counterfeit" in this context means the latter.

Team Intellectual Property has done their level best to lump all classes of 'products that they don't like' into a homogenous category of wickedness.

One would think that a meaningful distinction could be drawn between the following categories:

1. Fakes: Capsules full of god-knows-what fraudulently labelled as being something else and sold as such.
2. Counterfeits: Generic drugs (or non-OEM compatible FRUs, in situations like ink cartridges) fraudulently sold as being the name-brand good.
3. Unauthorized resale: Authentic goods being sold in some manner that makes the manufacturer a sad, sad, panda.
4. Authorized distribution: Authentic goods being sold as the manufacturer wanted.

Unfortunately for everyone, except for the blatantly self-interested parties, there has been a concerted effort to muddle the genuinely pernicious and dangerous class 1, and the possibly safe but definitely fraudulent, as in class 2, with the merely-cuts-into-profits-from-price-discrimination-between-countries of class 3.

Thus, while ICE will attempt to hunt you down if you are shipping in boxes of sugar pills labelled as some drug, or generic printer cartridges stamped "HP", they will also bust you for importing authentic Rolexes, legally purchased outside the US, if the trademark holder doesn't want you selling them in the US, despite them being 100% genuine product, with no theft or fraud in the distribution chain...

The FDA has its pros and cons; but the real kicker, to my mind, is the purely rent-seeking customs/trademark enforcement of restrictions on even drugs that are FDA approved in the US, and prescribed by licensed physicians, that are imported from countries where they sell for less.

I'm all for fraud being illegal(either people filling gelcaps with floor sweepings and rat poison and selling it as the real deal, or people selling generics as name brands); but the fact that that our 'free trade for me but not

He probably wasn't selling "counterfeit" drugs, any more than a pharmacy selling generics are.. more likely he did use the brand name to promote the sale of a generic though,.. As to "foreign".. ok, um in the first place Canada is technically a foreign country, so there's that.. and then there is the fact that we in the US pretty much buy everything foreign made.. known or not... so saying "foreign made" is supposed to be scary, or a crime ?.. Walmart would be the criminal masterminds of all time if sellin

US business is always preaching e benefits of free market capitalism, yet the drug industry is regulated and restricted in a manner that artificially inflates prices and restricts competition. If this person was selling counterfeit medicine, by all means throw the book at him for endangering lives. But if all he is doing is supplying a gray market product, he is actually serving a valid economic purpose by helping to push down the prie of essential medical supplies for an aging American population.

Very few US businesses preach free market capitalism. They preach managed market capitalism. They achieve that goal through the practice of crony capitalism. Crony capitalism increases in effectiveness with the size of government (and its power). And free market capitalism gets the bad rap as government power and size increases. Go figure.

US business is always preaching the benefits of free market capitalism,....

Yes, but most US businessmen are not capitalists, but monopolists. To give an sports analogy. If a runner tries to do her best and wins the race that's good, and races will thrive. If the runner tries to win the race by shooting her competitors, or getting rules to eliminate them, she might win one more race, but the spectators will go away, and no more races will be held. There must be competitors for there to be a race.

Monopolists try to wipe out the competition. The end game, if they are succe

Right now there are many levels of business pushing up drug prices. In particular, insurance companies need their profits. This became worse when Bush put the federal government in the equation with medicare part D. This allowed drug companies to use hundred of billions of dollars of tax payer money to keep the prices high. Those of us in the middle pay twice, once for out own drugs, once for subsidized drugs.

We should impose efficiencies in drug distributions. Ads are a waste of money. The alleged